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18 million kids didn’t get any vaccines in 2021

A baby girl receives polio vaccine drops
Reuters/Akhtar Soomro
Polio experienced the biggest drop in vaccinations in 2021
  • Annalisa Merelli
By Annalisa Merelli

Senior reporter based in New York City

Published Last updated

In 2021, the world conducted the largest vaccination campaign in history. More than 11.2 covid-19 vaccine doses were manufactured, and half the global population received at least one dose.

Yet the distribution was extremely unequal. By the end of the year, less than 5% of people living in poor countries had received a dose of covid-19 vaccine, while in wealthy nations up to 90% of the population was fully vaccinated.

But the consequences of vaccine inequality weren’t limited to covid. New data released by Unicef and the World Health Organization show that other immunizations lagged behind, too, particularly in poor countries. In 2021, 18 million children around the world didn’t receive a single vaccine.

In 2018, 86% of all children in the world received at least basic vaccinations, such as diphtheria, tetanus, and pertussis. In 2021, the data show, that percentage had gone down to 81%. This represents the most significant backslide in vaccine distribution in the past three decades. This might not seem dramatic, but it equals at least 25 million children missing out on lifesaving vaccinations. Further, these children tended to be concentrated in poor countries, where the chances of contracting severe disease is higher.

A drastic drop in vaccine coverage

In 2021, as many as 25 million children missed out on at least one of the routine immunization shots for diphtheria, tetanus, and pertussis, and about as many missed their first measles shot. And a majority of them, 18 million, didn’t get any kind of essential vaccines, including polio, measles, or HPV.

Among the most common vaccines, polio lost the most ground, going from 86% coverage in 2019 to 80% in 2021. Hepatitis lost 5%—from 85% coverage to 80%—and so did measles and the third dose of the combined vaccine for diphtheria, tetanus, and pertussis (DTP). Tuberculosis immunization coverage went down by 4%.

Covid was arguably the main reason for the drop, as it caused disruptions ranging from healthcare staff shortages, to supply chain issues. But other causes contributed , including an increase in children living in conflict or in fragile situations.

Recent outbreaks of measles and polio already show the risks connected with the steep drop in immunization.

An especially dramatic drop was in a less common vaccine, the one used against HPV. Only about 15% of the eligible girls are vaccinated against the virus, and a quarter of that coverage was lost in 2021. This is a severe setback for a vaccine introduced 15 years ago which reduces the risk of cervical cancer by close to 90%.

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